Daily Nebulizers Advised for Preschoolers With Frequent Wheezing

From Reuters Health Information

NEW YORK (Reuters Health) Oct 09 - The most effective way to manage frequent wheezing in preschool children is regular treatment with nebulized glucocorticoids, according to a report in the October issue of Allergy.

The authors of the report also suggest that as-needed use of a bronchodilator and glucocorticoid combination, which is commonly practiced, may be an alternative.

Dr. Leonardo M. Fabbri, of the University of Modena and Reggio Emilia, Italy, and colleagues conducted a trial in which 276 children ages 1 to 4 years with frequent wheeze were randomized to nebulized treatment with one of three regimens for 12 weeks: 400 mcg beclomethasone twice daily plus 2500 mcg salbutamol as needed; placebo plus a combination of 800 mcg beclomethasone/1600 mcg salbutamol as needed, or placebo plus 2500 mcg salbutamol as needed.

The primary outcome measure -- percentage of symptom-free days -- was significantly higher with daily beclomethasone (69.6%) compared with as-needed salbutamol (61.0%; p = 0.034).

Regular treatment with nebulized beclomethasone also improved several secondary outcomes, including nocturnal wakening and exacerbations.

There was no difference in percentage of symptom-free days between children with or without risk factors for asthma.

Allergy 2009;64:1463-1471.

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Worst Cities for Allergies 2009

Top Worst 10 Cities for Allergies and Asthma for 2009

1. St. Louis, MO
2. Milwaukee, WI
3. Birmingham, AL
4. Chattanooga, TN
5. Charlotte, NC
6. Memphis, TN
7. Knoxville, TN
8. McAllen, TX
9. Atlanta, GA
10. Little Rock, AR

See the rest of the top 100 cities worse for allergies at the AAFA website

Asthma-Swine Flu Q&A

Just wanted to direct you to a website, Asthma UK, that gives good, easy to understand advice for asthmatics who have questions on the H1N1 flu. My advice to all my asthma patients is that they need to get the seasonal influenza and H1N1 influenza vaccines. Also remember that children and pregnant women are high risk groups for the swine flu. Stay well, stay healthy.

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Seasonal Ragweed Allergy?

We are looking for participants for a study on investigational sublingual immunotherapy. To qualify you must be:

• 18 - 50 years old
• Received treatment for the condition for at least 2 years including the previous ragweed season
• Not on immunotherapy(allergy shots) within the last 5 years.

Please call 859-371-3797 and ask for the research coordinator.

www.AbrahamResearch.com

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A unique handy non-alcohol based, antibacterial/antiviral spray is available out there. This spray is currently being used by EMS/EMT, Law Enforcement and Health Care providers as an antiseptic agent that can be sprayed, even into the face, in the event of an accidental exposure to body fluids, such as blood, sputum or urine. This solution is non-alcohol based thus, non-irritating, and safe enough to be sprayed into the face for accidental exposure to potentially infectious fluids. Check their website at www.myclyns.com for more details.

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Immunotherapy Tablet Gives Fast, Durable Relief From Grass Allergens

From Reuters Health Information

By Scott Baltic

NEW YORK (Reuters Health) Sep 29 - A high-dose sublingual tablet containing allergens produced by the pollen of five grass species significantly decreases common allergy symptoms compared with placebo, from the first month of treatment forward, according to a report in the September issue of the Journal of Allergy and Clinical Immunology.

The immunotherapy tablet, Oralair Grasses, includes allergen extracts from five grasses: orchard, meadow, perennial rye, sweet vernal and timothy grasses. Oralair Grasses is manufactured by Stallergenes, Antony, France and marketed in Europe. It is not yet approved for use in the United States.

The tablet is safe and easy for patients to use, Dr. Friedrich Horak of the Medical University of Vienna, Austria told Reuters Health by e-mail, and is potent over a short treatment period, though only for grass pollen allergies. The once-daily treatment, he added, gives the advantage of good patient compliance.

The study is reportedly the first to evaluate the efficacy and onset of action of this desensitization tablet in an allergy challenge chamber. The chamber provides controlled conditions for measuring individuals' responses to a specific allergen concentration for a set period of time.

The randomized, placebo-controlled, double-blind trial recruited 89 participants between 18 and 50 years of age with histories of seasonal grass-pollen allergies. The 45 subjects in the treatment group received one immunotherapy tablet daily for the four month trial period.

Each participant underwent a two-hour baseline grass-pollen allergen challenge in the chamber before treatment began, and then again at one week and one, two and four months after starting treatment.

The primary outcome was the participants' average rhinoconjunctivitis total symptom score, which measures sneezing, runny nose, itchy nose, nasal congestion, itchy eyes and tearing.

A statistically significant improvement was seen in the treatment group after the first month, which was maintained at two and four months. Further, the total symptom score in the treatment group decreased at each successive challenge. In the patients showing the best clinical response to treatment, specific IgG (but not IgE) values were higher.

There were no serious adverse events.

J Allergy Clin Immunol 2009;124:471-477.

Flu Vaccines now Available

Get ready for the flu season. We are now giving the seasonal influenza vaccine injections. Call our office 859 371 3797 to find out how you can get your flu shots.